Serum carboxymethyllysine, an advanced glycation end product, and age-related macular degeneration: The age, gene/environment susceptibility- Reykjavik study

Richard David Semba, Mary Frances Cotch, Vilmundur Gudnason, Gudny Eiriksdottir, Tamara B. Harris, Kai Sun, Ronald Klein, Fridbert Jonasson, Luigi Ferrucci, Debra A. Schaumberg

Research output: Contribution to journalArticle


IMPORTANCE Advanced glycation end products have been implicated in the pathogenesis of age-related macular degeneration (AMD). OBJECTIVE To investigate the relationship between serum carboxymethyllysine (CML), a major circulating advanced glycation end product, and AMD in older adults. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study of a population-based sample of 4907 older adults (aged-66 years) in the Age, Gene/Environment Susceptibility-Reykjavik Study in Iceland. EXPOSURES Serum CML and risk factors for AMD. MAIN OUTCOMES AND MEASURES Early or late AMD, assessed through fundus images taken through dilated pupils using a 45° digital camera and grading for drusen size, type, area, increased retinal pigment, retinal pigment epithelial depigmentation, neovascular lesions, and geographic atrophy using the modified Wisconsin Age-Related Maculopathy Grading System. RESULTS Of the 4907 participants, 1025 (20.9%) had early AMD and 276 (5.6%) had late AMD. Mean (SD) serum CML concentrations among adults with no AMD, early AMD, and late AMD (exudative AMD and pure geographic atrophy) were 618.8 (195.5), 634.2 (206.4), and 638.4 (192.0) ng/mL, respectively (to convert to micromoles per liter, multiply by 0.00489; P = .07). Log serum CML (per 1-SD increase) was not associated with any AMD (early and late AMD) (odds ratio = 0.97; 95%CI, 0.90-1.04; P = .44) or with late AMD (odds ratio = 0.94; 95%CI, 0.82-1.08; P = .36) in respective multivariable logistic regression models adjusting for age, sex, body mass index, smoking, and renal function. CONCLUSIONS AND RELEVANCE Higher serum CML concentration had no significant cross-sectional association with prevalent AMD in this large population-based cohort of older adults in Iceland.

Original languageEnglish (US)
Pages (from-to)464-470
Number of pages7
JournalJAMA Ophthalmology
Issue number4
Publication statusPublished - 2014


ASJC Scopus subject areas

  • Ophthalmology

Cite this